Thursday, March 12, 2009

Pumping (or, couldn't you buy me dinner first?)

The pump and I have a love-hate relationship. Yes, it allows me to feed my child and it also allows my husband to feed my child, thus buying some freedom. It also feels like a ball and chain at times. Despite that, for me, it is a necessary evil as I am committed to breastfeeding as long as it works for us. And it is working.

Opinions from a less-than-expert ...
1. Start pumping early! I'm no lactation consultant, but it is really hard to find good advice about the pump. My LC told me to get out my pump one day at about 1 week old when I was really engorged and I thought I might be getting mastitis. It is super weird the first time, but you get the hang of it quickly. Ever since then I have pumped almost every day, with the exception of when the Girl was going through a growth spurt.

2. We started with the bottle at about 3 weeks, so I would pump while Dad gave her a bottle. Initially I would pump first and then he would give her the freshly pumped milk, but I couldn't quite keep up, so it was better to have a bottle ready to go and then pump at the same time for the next day's bottle.

3. I started off giving Girly 4 oz. Again, very little direction on this, but you might have a better idea if you use formula. She gobbled it up. I think a rough formula is 24 ounces in 24 hours - just divide by the number of feedings they are getting and that is the approximate right number of ounces. Some kids more, some kids less.

4. Use the Soft Fit breastshields if you have a Medela pump - seem comfy and the LC at the store I go to says she won't sell anything else now.

5. I use the microwave sterilizer for everything, but I find that the milk fat doesn't really come off the bottles well after they have been in the fridge with milk in them. Use the dishwasher for bottles at that point. Life is too short to wash bottles by hand.

6. From about 1 week-6 weeks Girly would have random times when she would only eat on one side (I always offered both and she averaged 10min/side). I would pump the other side because I wanted to keep my supply up, didn't want my boob to hurt, and it was a good way to build up a little supply in the fridge.

7. When Girly first started sleeping much longer stretches at night (around 7-8 weeks) I would only feed her on one side when she woke up in the morning. This will totally depend on your baby, but I was very engorged and she would choke and sputter and spit up if I fed her on both sides. She seemed satisfied after one side, so that was it. Then, I would pump both sides (double pumping is always more effective than single pumping) and I would get lots of milk. I have continued to do this every morning, but it is a bit of a Catch-22. If I weaned off the morning pumping I could nurse her and get out of the house much quicker before work, but I get SO MUCH milk when I pump first thing that I am afraid my supply will drop and I won't be able to keep up with her bottle demands for daycare. So, pumping it is. Now I put the pump and bottles by my bed the night before I have to work so I can just barely wake up and do it while I watch the news.

8. Details: I tried to read a lot online, but the info varies so much. Many websites say it is normal to only get 2-4 ounces TOTAL when you pump both boobs. I found this was pretty close to what I would get when I pumped during the day, but I just couldn't see how I would ever keep up with the Girl's bottles if she took more than 4 ounces each time. Plus, when I asked my friends, they all said they got a lot more! So ... I started pumping 15 minutes each time I pumped (or, longer if you still see drips), which gradually helped a lot. I also add in an extra "feeding" each day - the Girl nurses 5 times and gets 1 bottle and I pump twice, to make 7 "feedings". I have GOBS of extra milk in my freezer at this point, but I wanted to try to bank as much as possible before going back to work. Try these things, or adding a beer a day, before using meds to increase your supply. In just a few weeks time I now have 200+ oz. of milk in my freezer.

8.5. This isn't to say that meds don't work. I have several friends who have used Fenugreek and prescription meds with great success. I was just hesitant to start because I didn't think I had a low milk supply, I thought I just needed better pumping habits. As it is now, I feel like I spend all of my time on "milk maintenance" and I can't imagine if I was pumping MORE than I already am.

9. Freezer supply: My LC told me to have about 30 oz. in the freezer when I went back to work. Sounds like a lot, but really that is only about 2 days at daycare! Build up as much as you can. And, here is the catch - I read that you really shouldn't use your freezer supply unless you really have to. Once you start relying on that to meet the baby's bottle needs for the day, your body interprets that to mean you need to make that many fewer ounces each day and it is a vicious cycle until you make too little to feed the baby and your freezer supply is gone. I just plan to use it in emergencies and when I am weaning her.

10. As for milk storage, I will leave fresh milk in the fridge up to 4 days before giving it to her or freezing it. I follow the La Leche League guidelines - figure they know what they are talking about. My pump doesn't go directly into bags, so I transfer from the little bottles. I was using the medela bags, but they are pricey, so I am switching to Lansinoh. Also, I have a milk storage gizmo in my freezer that works great to smoosh the bags flat. When this is full, I transfer the frozen blocks to those ziploc throw-away tupperware things. The rectangular size works great.

11. I've said before that we use the medela bottles and they work great for the Girl without adding a step of transferring milk to another bottle. I have about 20 of the 5oz bottles and we still go through them like crazy - 6 for me and 4 for her each day I work, plus random overflow bottles in the fridge from pumping. Eventually, she will take more than 5 oz and these bottles won't be so useful. As it is now, when I pump first thing in the morning I can fill up a bottle. I got some cheapy 8oz Evenflo bottles for the morning pump. They are bpa free and fit medela pumps. Dr. Browns bottles also fit the medela pump if you use those.

12. Keeping track! I used sticky notes at first to keep track of what day I pumped the milk. In a stroke of genius (at least I would like to think so) I got a narrow dry erase marker to write the day of the week on the cap. Now I also use it to keep track of daycare bottles and first morning bottles. Wipe it off before you throw it in the wash.

13. Vitamins - our doc recommended PolyViSol since the Girl was exclusively breastfed. I put the dropper of goo in her daily bottle so we don't battle to get it in her mouth, She doesn't seem to care. I also put her tylenol in her bottle after she had her first shots. I don't yet feel confidant getting the whole dropper in her mouth and this eliminates the guesswork. Also, after Ellen's first shots she screamed when I laid her down to breastfeed because her legs hurt. Next time, I'll probably just plan for the bottle.

14. Finally, if you are pumping when you go back to work, you will hopefully be pleasantly surprised at your supply. I almost never pumped during the day - just first thing in the morning where I got tons, and late in the day when I had much less, which is pretty typical. I have pumped a lot more in my first week back than I would have expected. Good so far!

1 comment:

mary_marshall said...

Which milk storage smoosher do you have? I'm looking into some because I'm bogging down the freezer with these milk bags! You can email me: thanks!